How to go ahead??

patient had come with unstable left lower limb history of rta 1yr back, sustained open injury of left lower end of tibia fracture. treated elsewhere with external fixator and flap coverage. what can be done??




Gap nonunion tibia LRS and bone transport an option Fibula management depends on presence or absence of infection If no infection, retrograde intramedullary nail to maintain alignment: Definitive fixation after tibial bone transport Ankle joint may be fused Check movements

Thank you doctor. There is no infection but skin is not good and adherent to bone post skin flap. Ankle movements are there slightly restricted may be due to disuse. I was considering fibular osteotomy and strut grafting along with iliac bg stabilization with ilizarov's for later lengthening procedure.